Test/Exam Confirmation

Services for Students with Disabilities (SSWD) can assist instructors with the administration of accommodated tests and exams. If you would like SSWD to provide the required accommodations, then please complete and submit this form to SSWD no later than 7 days before the test/exam date.

Test/Exam Confirmation

Test/Exam Information

Instructor Name: *

Instructor Email: *

Course Code (include cross-listed): *

Date: *

Test/Exam Start Time: *

:

am

pm

Test/Exam End Time: *

:

am

pm

Parameters

Please note:
1. All multimedia content needs to be provided no later than 3 days before the exam/test.
2. We cannot accommodate exams that require software not listed in this section or that require a specific lab/class environment.
3. Please include software versions in the comments field below.

Lecture Following Test/Exam: *

Yes

No

Question Format: *

Multiple Choice, True/False

Short Answer

Essay

Diagram

Fill-in-the-blank

Problem Solving: Equations and Symbols

Problem Solving: Other (Words and Sentences)

Online Isaak/Sakai

Answer Format: *

Exam Script (Answer on Exam Paper)

Scantron Form

Examination Book

Submit Online

Support:

Open Book

Calculator

Dictionary (English)

Dictionary (Other)

Formula Sheet

Cheat Sheet

Language Translator

Multimedia:

Audio

Video

Software:

Word (2010)

Excel (2010)

PowerPoint (2010)

SAS (9.2)

SPSS (19)

Maple (15)

Minitab (16)

Other Information

What do we need to know in order to administer the test/exam?

Comments:

Contact Information

Where/how you can be reached during the test/exam

Room: *

Phone Number:

Completed Tests/Exams

Completed tests/exams can be picked up from ST411 (they will be returned by inter-office mail tracking system if not picked up within 3 business days).